Jackson Randolph, MD
NPI 1063040970 · Otolaryngology Physician · San Luis Obispo, CA
Enrolled with Medicare as Practitioner - Otolaryngology · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Jackson Randolph, MD is a Otolaryngology Physician provider in San Luis Obispo, CA (NPI 1063040970).
Provider details
- NPI number
- 1063040970
- Entity type
- Individual
- Primary specialty
- Otolaryngology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- A202960 (CA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 2 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Oxycodone Hcl/Acetaminophenbrand: Oxycodone-Acetaminophen | 19 | 18 |
| Fluticasone Propionate | 17 | — |
Medicare Part D only. These counts cover prescriptions paid through Medicare Part D in 2024 — they do notinclude cash-pay, commercial-insurance, Medicaid, or Part B–administered drugs, and badly undercount high cash-pay categories (e.g. GLP-1 weight-loss, testosterone, and ED medications). Any drug with 10 or fewer claims is omitted by CMS, and beneficiary counts under 11 are suppressed — so a missing drug means no Part D record, never zero. This is a factual claims summary, not an endorsement, not medical advice, and not a consumer report. Source: CMS Medicare Part D Prescribers — by Provider and Drug.
Practice location
Mailing address
Registry dates
- Enumerated
- 2020-03-28
- Last updated
- 2025-06-14
- Certified
- 2025-06-14
Frequently asked questions
- What is Jackson Randolph's NPI number?
- Jackson Randolph's National Provider Identifier (NPI) is 1063040970, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jackson Randolph's specialty?
- Jackson Randolph is listed in the NPPES registry with a primary specialty of Otolaryngology Physician (Allopathic & Osteopathic Physicians).
- Where is Jackson Randolph located?
- Jackson Randolph's practice location on file with NPPES is 35 Casa St Ste 130, San Luis Obispo, CA 93405-1887.
- What is Jackson Randolph's phone number?
- The practice phone number listed in the NPPES registry for Jackson Randolph is (805) 541-1422.
- Does Jackson Randolph accept Medicare?
- Jackson Randolph is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Jackson Randolph's NPI active?
- Yes — Jackson Randolph's NPI (1063040970) is active in the NPPES registry as of the last update on 2025-06-14.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.